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Writer's pictureDavid Chen, DDS

Wisdom Tooth Decay - Common Problem?

Updated: Nov 13, 2023

It is not uncommon for wisdom teeth to have tooth decay because they are still a type of teeth and all teeth can get cavities. They have an enamel layer, dentin layer, and pulp layer just like all of the other teeth in your mouth. There is nothing different about them that would make them immune to tooth decay.


third molar cavity by gumline
third molar cavity by gumline

One of the most common reasons for having wisdom teeth removed is pain from having a cavity in them. Aside from that, the other reasons for having them removed would be if they caused inflammation or they were impacted.


This article will explain why these teeth are more prone to cavities and how you can treat them. We'll also help you weigh your options for whether or not you should have them extracted.



Table of Contents:



Why are wisdom teeth vulnerable to cavities?

Wisdom teeth are more prone to cavities than all of your other teeth due to their position in the mouth and also because they're more difficult to clean.

  • Position. Your wisdom teeth are also known as your third molars because they're the third set of molars in your mouth. Consequently, they're the last ones to erupt through your jaw so they are positioned as the last tooth in your mouth. You have four of them in all four quadrants. Since they are so far back, most people tend to miss them while they're brushing and flossing because they don't go far back enough.

  • Difficult to clean. Most people have trouble flossing their teeth due to inadequate hand dexterity along with having hands larger than their mouths. This combination makes it difficult for most people to floss their wisdom teeth. That makes them more prone to cavities.


wisdom tooth covered in plaque
wisdom tooth covered in plaque

What does decay on wisdom teeth look like?

Cavities on wisdom teeth look like cavities on any other teeth. The only difference is that they are located on your third molar, which is the last tooth in your mouth.


cavity on top of wisdom tooth
cavity on top of wisdom tooth

Appearance:

  • Black to brown in color

  • Can be soft if you poke it

  • May be cavitated with a hole

  • Can be painful or painless


How to treat tooth decay in a wisdom tooth

Depending on the size of the cavity in your wisdom tooth, the treatment will differ. A cavity filling may be sufficient for a small cavity. A large cavity may require the entire third molar to be extracted from your mouth.

  • Tooth filling. A cavity filling requires you to be numb. This procedure removes the decay and then fills it back in by restoring it with a composite resin. That is a tooth colored filling material. An alternative would be a silver filling instead.

  • Tooth extraction. Getting your tooth removed will definitely require you to be adequately numb, otherwise it wouldn't be a pleasant experience. This procedure is irreversible because once you take the wisdom tooth out, it won't grow back. This is typically reserved for very large cavities, which renders the tooth non-restorable.


Root canals are an option for medium to large sized tooth decay for wisdom teeth. However, they're typically NOT recommended due to unpredictable canal variations and morphological variations for third molars. What this means in lay man's terms is that the success rate is very poor. Essentially, you may be wasting your money if you attempt a root canal on a wisdom tooth.



Does wisdom tooth decay with no pain still need treatment?

All forms of tooth decay, regardless of whether or not they are painful will not go away on their own. Therefore the short answer is yes, even if your wisdom tooth decay is not hurting you, it still requires some form of treatment.


If it is not painful, there is a good chance that the cavity on your tooth isn't very big. Tooth decay usually won't hurt you until it gets big enough to reach the nerve. Once it gets that big it'll require either a root canal or a tooth extraction. Untreated cavities will progress through all of the stages of tooth decay without fail.


Basically, if you have decay but its not hurting it is an opportunity for you to treat it early by having just a small filling on it. If you procrastinate and put treatment on hold, it may grow to a size where you may no longer be able to save the tooth from removal.



Is it possible to postpone extraction for wisdom tooth decay?

It is not recommended to wait on extracting a wisdom tooth with decay that needs it because cavities will not go away on their own. They will slowly get bigger and bigger until it eventually causes you pain.


You may think that you can wait on it since it is not hurting you but do you really want to wait until it does before you take care of it? Wisdom teeth pain often come at the most inopportune time such as when you're about to leave for vacation or you have some other obligation to attend to. It would be prudent to take care of potential problems so that it does not disrupt your life.


If that doesn't convince you... if you were in pain you may not necessarily be able to get an appointment with your dentist the same day. What if they didn't have an available until a week later? Could you endure wisdom teeth pain for an entire week? Due to this reason alone, we recommend that you stay ahead of the pain and not follow behind it, if that makes sense.


To summarize, you can postpone taking the wisdom teeth out IF they are not in pain but it is not wise to wait on them. You should try to get them treated as soon as possible. That way it is on your time and in your control.



Takeaway

Wisdom teeth are not immune to tooth decay. Fortunately, treatment for them is the same as tooth decay on any other tooth in your mouth. For small cavities it may just need a filling but larger ones may need the entire tooth removed.


The only difference is that your third molars do tend to be more cavity prone than all of your other teeth. The reason has to do with how far back they are, which makes them extra difficult to keep clean.


Aside from that, you just need to take care of them as if they were any other tooth! You still need to brush them twice a day for at least two minutes each. Try your best to floss them even though it may be difficult since they're so far back. Last but not least, minimize the amount of sugar that you eat so that you decrease the chances of them becoming decayed.


If you're not sure if your tooth is decayed, you should schedule a consultation with your dentist. If you catch them early, treatment for them can be more conservative.

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About the author: Dr David Chen, DDS

Hello, I'm Dr Chen and I'm an actively practicing dentist in Long Island City, NY. I graduated from Columbia University College of Dental Medicine in 2016 but prior to going to dental school I was already working in the dental field. It's been more than a decade since I first got to know dentistry and let me tell you, time flies by quickly. Since then I've developed a fondness for writing, which is how this all got started!

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Medical Disclaimer:

This blog is purely meant for information purposes and should not be used as medical advice. Each situation in your mouth is unique and complex. It is not possible to give advice nor diagnose any oral conditions based on text nor virtual consultations. The best thing to do is to go in person to see your dentist for an examination and consultation so that you can receive the best care possible.

The purpose of all of this oral health information is to encourage you to see your dentist and to inform you of what you may expect during your visit. Due to the unfortunate nature of dentistry, there isn't really any true home remedies that will get rid of dental problems. Roughly 99.99% of them require in-person intervention by a healthcare professional.

Hint: That is the reason why you can't eliminate seeing dentists in your life!

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